Acupuncture and Nutrition Clinic – Houston

Allergies are in full bloom these days. I actually started seeing the itchy, watery, sneezy, goopy stuff in the office starting in January, but it’s in high season with the budding and flowering of our trees and bushes. The good news is acupuncture and chinese herbs are a great way to beat the allergy blues while concurrently building your immune system to better fight the allergy problems for next season. I can say that my patients who started last year to treat allergies are doing significantly better during this allergy season as a result of previous treatment. One patient told me it’s the first time she has not developed bronchitis and a severe environmental allergy attack in years.

I used to have allergies. After taking some allergy medication and almost going off the road in a hallucination type of reaction with my scalp feeling like it was crawling, I decided to get off the prescription drugs. Luckily it was about the same time I started studying acupuncture and Chinese medicine. That was twelve (12) years ago and I have not had one bout of sinusitis or an allergy attack since. (I also have not been to the chiropractor in the same amount of time for a back adjustment). It’s amazing how the benefits extend to the whole body with acupuncture!!

Even though we recently had some good rain to wash some of the pollen out of the air, I am continuing to get calls from people who are at their wits end with allergies. All of these new patients have tried everything Western medicine could offer and finally decided to give acupuncture and Chinese herbal therapy a try.

Treating acupuncture in Chinese medicine generally involves the Spleen, which manages the distribution of fluids-think congestion, runny nose, dampness as well as the stomach and Large intestine channels (as they traverse the face, nose and sinus areas). Interesting those channels that affect the digestion have a lot to do with allergies that affect the face, nose, sinus and lungs. It makes sense that a strong, healthy core makes for a healthier body.

I get great satisfaction treating patients who have had long standing issues with allergies. The response can be fast, like right on the table. Congestion, post nasal drip, runny nose quite often is relieved within minutes of an acupunture treatment. Truthfully, it takes more than one treatment to resolve a long standing problem, but in the interim of treatment, symptoms go away while we gently strenthen the lungs and spleen and make you stronger for the next season of allergies. The good news is that patients often will become less dependent on prescription medications for managing their allergy symptoms. My patients are always amazed and pleased about that. Why wouldn’t you want to be more drug free?

One of the best professors that I ever had in Chinese Medicine school was doctor James Giordano. Dr. Giordano taught pathology to Western and Chinese medical students. In my second year of school, I remember when he listed the five cardinal signs of inflammation; redness, heat, swelling, pain, and loss of function. I learned that inflammation can occur anywhere in the body and can be of an acute or chronic nature.

Acute inflammation usually occurs when there is a trauma to the body. There are two kinds of physical traumas; blunt and penetrating. Blunt traumas occur when the impact or force of another object is significant enough to cause physical injury and penetrating trauma happens when the skin or tissues are pierced by an object or burned. Dr. Giordano explained that as soon as cells are damaged, the body responds immediately to protect the injured area. Initially, the blood vessels dilate and increase blood flow to the traumatized area creating the first cardinal sign of inflammation, redness. Soon afterward, fluids leak into the tissue creating the second cardinal sign, swelling. If trauma is on the surface of the body the increased blood flow to that area causes the third cardinal sign, heat. Heat occurs because the temperature of the skin is normally less than that of the blood. The fourth cardinal sign, pain, results from pressure and swelling. Additionally, cellular chemicals called kinins stimulate pain receptors and tell blood vessels to dilate. Finally, the fifth cardinal sign, loss of function occurs as the body attempts to protect theinjured area. In an acute inflammatory conditions is not treated effectively it may become chronic. Western medicine’s approach to the treatment of inflammation includes pain medications, steroids and in some instances chemotherapy.

It is difficult to establish a direct correlation between Western and Chinese medical views on inflammation. Each medical practice has its unique way of looking at inflammation. For example, the first cardinal sign for inflammation, redness is viewed in western medicine as increased blood flow to the injured area. In Chinese medicine, it signifies that there is heat. Western medicine views pain resulting from pressure from the increased blood flow and swelling, while Chinese medicine describes pain as obstruction or stagnation of the energy (qi) and blood.

Chinese medicine considers the constitution of the individual, the progression of the pathological changes, and the specific imbalance in the body before determining the frequency of the treatments as well as the specific herbs and acupuncture points to be used. The flexibility inherent in Chinese medicine to choose from a variety of treatment options reflects a very sophisticated form of medicine intended to treat each patient in an individualized manner. For this reason, Chinese medicine is very effective in treating inflammatory conditions. It is therefore not surprising to see chronic inflammatory conditions such as osteoarthritis, rheumatoid arthritis, lupus, fibomyalgia, crohn’s disease, and colitis to respond positively when treated Chinese medicine. The frequency of treatment will depend on the severity of the problem. Severe conditions are generally treated several times per week, while less severe inflammatory problems can be effectively treated on a weekly or bimonthly basis.

In many ways we should consider ourselves healthcare customers. We are customers with our doctors just like we are customers in a restaurant or store. There are certain ways we expect to be treated. If we don’t like the service in a restaurant or how a salesperson has spoken to us, we have the right to leave and to complain to management. When it comes to healthcare and medicine, I also believe that we can have a say in how we are treated and to ask as many questions as necessary to understand what is being recommended for our care.

I do believe everyone with a new condition or problem should be evaluated by a medical doctor. Western medicine does have the best diagnostic equipment in the world. Western medicine is also the best for emergency medicine.

When there is a non-emergency or chronic condition, we can become advocates in our own healthcare. It’s good to hear what the doctor recommends and take it under consideration. Afterall, the doctor does have your best interests in mind. But the doctor may not be well versed in options that may be less invasive or requiring less medications. This is where we as patients have a right to have a voice in our treatment process.

I believe that one of the many reasons acupuncture has become such a popular option for many, is that in addition to making all kinds of physical problems better, acupuncturists listen to patients and treat them as a whole person. The doctors today who still subscribe to the “my way or the highway” mentality are not the doctors that patients like to go to or speak well of to others.

So, it’s up to us, as healthcare customers to consider all of the options to treat our specific problem. Because there are alternatives and different ways to treat problems, we have to do our research and find out what might work as well or even better and with fewer side effects.

Just because a doctor tells you to take another drug or have asurgery, (it might be that you need to take that drug and have that surgery), you can also wonder and question whether there may be another way to treat the pain or deal with the problem (reflux, depression, hot flashes, migraines, etc). Is it possible to manage or treat the problem without drugs? Can surgery be avoided through acupuncture and physical therapy? Remember, once you cut, you can’t go back. It’s certainly worth trying everything before undergoing anesthesia. So I do think we have to be smart consumers of medical care. It’s about taking responsibility.

We are very lucky in Houston as we have a world class medical center and hospitals and world class doctors. But it’s also ok to have a little healthy skepticism and consider all our options.

This is a comment I had from a recent patient.

“I went into a regular doctor to get my hot flashes treated and they ended up prescribing antidepressants which I chose not to fill and chose not to proceed with because I’m not a depressed person.”

There are some antidepressants that doctors prescribe for hot flashes and symptoms of menopause that seem to help some people. But of course taking antidepressants is not for everybody and they are not without side effects. My preferred approach to treating menopausal issues is with acupuncture and herbal therapy.

When I was learning about menopause and hot flashes during my studies, it was as if a light bulb went off. It was that special aha moment. An interesting way to understand hot flashes is to first get the concept of Yin and Yang. One of my previous blogs talks about Yin and Yang.

To reveiw briefly, Yin, our moist, cooling energy and Yang, our hot, rising energy should be in relative balance. As we age, our Yin and/or Yang energy becomes deficient. For many who experience the internal heat sensations of hot flashes, it means that the cooling energy has become depleted causing a relative excess (too much) of the Yang, hot energy. The heat is not coming from the outside, but from the inside and rises up into the head and face area.

Treating the hot flashes in Chinese medicine is more about strengthening the Yin energy thereby cooling the relative excess of Yang (hot) energy. It’s not about trying to trick the body into thinking we are younger hormonally again by giving hormone replacement. It’s more about tonifying or strengthening the Yin, cooling energy which has become depleted over time.

When I learned that, I said, “Wow! What an interesting common sense way to understand the mechanism of hot flashes in menopause!” The treatment goal in Chinese medicine for hot flashes is to tonify or strengthen what has become depeleted. We increase the Yin, cooling, moisturizing part of us to put the Yin and Yang back in balance. The goal is not necessarily to reduce the Yang by itself because it’s only elevated due to too little of the Yin. It’s better to treat the root of the problem (too little Yin) rather than treat the symptom (too much Yang). It’s a beautiful way to treat the symptom while treating the root of the problem. So what I do is I put needles and give herbs to help tonify and strengthen the cooling mechanism so the Yin and Yang are in balance and the hot flahses are reduced or eliminated.

I love treating menopause because along with hot flashes comes disturbed sleep, irritability and mood swings. Acupuncture can help regulate a lot of those problems.

What’s important to understand with Chinese medicine and menopause and hot flashes is that our goal as acupuncturists when a woman comes in is to help a woman through this time in her life. It’s to help balance them so their life isn’t defined by menopause.

I have a lot of patients who do not want to take hormone replacement. The acupuncture helps. I have helped women wean off of hormone replacement who didn’t want to take it anymore. So it’s certainly a very viable option to try. It makes sense because the heat comes from inside. It makes complete sense that your cooling mechanism is off.

In the previous blog, I gave a brief description of what Yin and Yang represent. In short, it’s about warming and cooling energy. This blog is taking you to another level of understanding in Traditional Chinese Medicine (TCM). This post will explore the concepts of Qi (chee) and Blood and how and why they are fundamental components in TCM.

The concept of energy in TCM, is referred to as Qi (chee). The Qi energizes the body, moves and warms. Therefore Qi has Yang energy. (See Yin and Yang from previous blog). Blood and body fluids are sustenance for the body. They nourish and moisten the whole of the body and therefore are Yin in nature.

The strength of our Qi comes from our Prenatal or Congenital Qi (our parents) and Acquired Qi from our food and air. Qi is the source of movement in all directions. Qi protects the body like a shield against pathogens (i.e. viruses) and allows for bodily functions to work efficiently. Qi warms the body and ensures the appropriate flowing/movement of substances in the body, like blood and body fluids.

Qi can be deficient as in infirmity of old age, chronic illness or malnutrition. It can collapse as in prolapse of organs (bladder, uterus). Stuck Qi (stagnant Qi) results in feeling deep, achey pain, a sense of distention and/or emotional upset. Qi can also flow in the wrong direction (rebellious Qi) manifesting as cough, nausea, vomiting, hiccups, dizziness and diarrhea.

Blood as we know it is a thick liquid and therefore one of the most dense forms of Qi (Yin in nature). In TCM like in Western medicine, Blood functions to nourish the body. In TCM it is understood to flow and circulate in the meridians. Blood flow in the meridians includes the organs and tissues of the body as well as body hair, tendons, ligaments, bones and viscera. It moistens and nourishes the whole body, especially the eyes and tendons. Hair growth is related to quality and amount of blood.

In TCM the three most important organs related to Blood are the Liver, Heart and Spleen:
-“Liver stores and regulates the blood; when the body moves, the blood will flow through the channels. When the body rests, the blood returns to the Liver and is stored.”
-“The Heart governs the blood, which means the Heart pumps the blood.”
-“The Spleen contains the blood which means the Spleen manages the blood by preventing the
blood from spilling out into the vessels, i.e.: hemorrhaging, bruising.”

Qi (energy, life force) moves the blood and keeps it circulating. Without strong Qi to move the blood, the blood will gather and get stuck. The areas where blood stagnates will result in pain and disease as a result of inadequate blood moving and nourishing the body. The interaction between Qi and Blood is significant. If our Qi is weak, it won’t be able to sufficiently move the blood. If our blood is deficient it won’t nourish and moisten the body and will also result in disease and pain.

Disorders of the Blood include blood deficiency, blood stagnation and heat in the blood. The reasons for this could be from blood loss, reduced blood production or the blood nourishing qualities being reduced. General signs of blood deficiency include dizziness, palpitations, lusterless complexion, pale lips, insomnia, dry skin and hair. It may not show up as anemia in Western medicine but would still be considered blood deficiency in TCM. Other problems related to blood deficiency include amenorrhea or shortened menstrual cycle, and dry, itchy skin.

Some of the causes of blood stagnation come from Qi deficiency not moving the blood, heat in the blood and impact trauma causing hemorrhage or bruising. The generals signs of blood stagnation include purplish lips and tongue and/or papules on the tongue. Local areas of blood stagnation would manifest in painful swelling or knife-like stabbing pain. Bleeding can occur when the blood vessels can no longer hold the pressure caused by the stagnation and the blood will be a dark purple-black. Western diseases that relate to blood stagnation would include a heart attack or stroke.

Heat in the blood is a result of heat toxins entering the blood. It is characterized by rapid blood movement, hemorrhage and/or deep red rashes, eruptions on the skin or hives, and dry mouth. Heart-Blood heat will cause anxiety, mental illness and mouth ulcers. Blood heat in the uterus will cause excessive bleeding during the menstrual cycle.

When we diagnose in TCM (Traditional Chinese Medicine), we observe a person’s expression,  facial characteristics,  appearance of the body,  tongue shape, color, coating and markings and feel the pulses on both wrists. We listen to what the patient says, ask specific questions about the working of the body and palpate areas the patient is complaining about. All of the above helps give a picture of what is going on inside the body. The answers and observations during the interview help form a TCM diagnosis.  The diagnosis will include an assessment of the quality and balance of Qi (pronounced chee), Blood, Yin and Yang. In this blog, I will be discussing the concepts specifically of Yin and Yang. Subsequent blogs will explore  the meaning of Qi and Blood,  what we look for in examining the tongue and pulses, facial diagnosis and more.

The concept of Yin-Yang is considered one of the most important theories in Chinese medicine. It is said that all the functions of medical physiology, pathology and treatment can be reduced to Yin-Yang. Yin-Yang and Qi (pronounced chee), are the main concepts that have been explored over the centuries of Chinese Medicine. Yin and Yang repesent opposite but complementary qualities as I will describe below.

The functions of Yin are to cool, nourish, moisten and to allow us to be restful. When Yin and Yang (warm energy, see below) are in balance, the body temperature is even. When Yin and Yang are out of balance the body will have uneven flow of energy which will create pain and/or disease. Yang functions to warm the body,  transform energy and protect the body from external pathogens (like viruses) by providing a strong Defensive Qi (life force).

Yin is associated with the female gender, is colder in temperature, and has a sinking, inward, heavier energy. It is strongest at midnight and tends to affect the lower body, the interior of the body and abdomen. Yin seasons are Autumn and Winter.

Yang is more male, with a hotter temperature, and is associated with a lighter energy. It has an upward, outward movement and is reflected on the upper body, exterior of the body and back. Maximum Yang is noon. Yang seasons are Spring and Summer.

So based on this information, one can understand how a deficiency of Yin might lead to dry mouth and throat (not enough moisture), low grade fever or flushing (cooling mechanism not working) and night sweats. A deficiency of Yang (warming energy) would give rise to an aversion or strong dislike of cold, pale complexion and a preference for warm/hot beverages and layers of clothing.

When there is too much Yin (cold energy, too little Yang, warm energy) one may feel listless, apathetic, sad or discouraged. Muscle tone is usually poor and the body/skin is cold. Quite often there is a flat affect (lack of expression) and a generally weak body energy. This weakened state results in a slower metabolism (compensatory mechanism to spare the body) and circulation and a pattern of sleeping too much. Hands are colder than feet and face is cooler.

An excess of Yang (too much hot energy, too little cold) manifests with a more aggressive and boisterous personality. Muscle tone is usually firm with a ruddy complexion. The body tends to feel warm, with fast, strong movements and gestures. Metabolism and circulation are normal to rapid and there tends to be problems with insomnia and agitation. The  upper body is generally warmer with cold feet.

Are you finding a pattern for yourself? Maybe you have some of both? Human beings are more complex than just Yin or Yang excess or deficiency. We usually have a combination of too much of one,  too little of another or too little of both. Throw into the mix a concurrent imbalance in Qi and Blood and you can understand how complicated a treatment strategy can be. The challenge for the practitioner is to address the most immediate and acute problem and then treat for the underlying (usually a chronic condition) problem while working to gently adjust the Yin and Yang, Qi and Blood to a more balanced energy flow.

Yin and Yang as described above are opposites. However, as opposite as they seem, there is also a relativity to the concepts. As nothing is completely Yin or completely Yang. Each has a part of the other. Yang is considered hot and Yin is cold. But hot and cold are still relative to each other. For example: in Houston, one might consider 40 degree weather as cold. But relative to Chicago, that level of cold might be considered moderate.

Yin and Yang although opposites are also inter-dependent on each other. One cannot exist without the other, even though they are mutually exclusive. Day does not exist without night, activity requires rest.

Yin and Yang have a dynamic balance. When one is out of balance, the other is affected. If we have too much Yang, there is inadequate Yin. Too high a fever (Excess Yang) creates a deficiency of cooling, moist energy (Yin).

Lastly Yin and Yang do not stay the same. They have the ability to transform into each other. The changes of the seasons or day into night are examples of how Yin and Yang transform into each other.

A forthcoming blog will discuss some of the health  issues that arise from an imbalance of Yin and/or Yang, Qi and Blood. So, stay tuned…